Service provision and dietetic reflections on the management of gastroenterology patients.
In December 2017, with the support of the British Dietetic Association, Dr. Schär undertook a survey of UK registered dietitians with the aim of gathering information regarding service provision and clinical reflections on the management of patients with coeliac disease and irritable bowel syndrome (IBS). We were delighted that 749 survey responses were submitted, providing a wealth of information that we have been able to share with the BDA and dietitians with a specific research interest in these areas. For your information, we take pleasure in providing some key highlights from our survey results below:
- The ability for dietitians to provide services in specialist gastrointestinal clinical settings is limited: 35% of dietitians who regularly advise CD patients do so within their general hospital clinics. Furthermore, 63% of dietitians who regularly advise IBS patients do so within general clinics.
- Many CD patients may not be receiving access to annual dietetic review, as is recommended within the NICE Quality Standard for Coeliac Disease (QS134 2016): 45% of dietitians who are regularly advising CD patients are unable to offer an annual review appointment or only able to offer an appointment if clinical need arises. This is perhaps a reflection on the huge pressure facing NHS services and is a call to action for us to consider new and innovative ways of delivering dietetic services to patients in an effective, timely and cost-effective way.
- The majority of dietitians are required to advise patients with IBS but many may require additional training. 62% of respondents reported to regularly advise patients with IBS, however only 52% of these are currently able to offer low FODMAP advice. Given the wealth of research proving the efficacy of this approach in the manangement of IBS, and the positioning of the low FODMAP diet within IBS clinical guidelines, these findings perhaps highlight a significant need for greater access to post-registration training.
- Onions, garlic and wheat are the most commonly avoided foods in the long term, following the reintroduction phase of the low FODMAP diet. Amongst those dietitians who regularly advise patients with IBS, 79% report that onion is one of the most likely foods to be poorly tolerated in the long-term, followed by garlic (68%) and wheat (59%). This finding perhaps validates the current research interest in the area of modified low FODMAP diets.
www.drschaer-institute.com